Benefits of prolonged infusion of beta-lactam antibiotics in patients with sepsis

"Prolonged infusion of beta-lactam antibiotics in comparison to the intermittent infusion has the theoretical advantage of better patient outcomes" Rafailidis et al (2020).

Abstract:

Introduction: In the current era of relatively scarce antibiotic production and significant levels of antimicrobial resistance, optimization of pharmacokinetics and pharmacodynamics of antibiotic therapy is mandatory. Prolonged infusion of beta-lactam antibiotics in comparison to the intermittent infusion has the theoretical advantage of better patient outcomes. Apparently, conflicting data in the literature possibly underestimate the benefits of prolonged infusion of antibiotic treatment.

Areas covered: We provide our perspective on the subject based on our experience and by critically evaluating literature data.

Expert opinion commentary: In our opinion, the available data are suggestive of the beneficial role of prolonged infusion of beta-lactams in regard to piperacillin/tazobactam and carbapenems after administering a loading dose. While more data from randomized controlled trials are necessary to solidify or negate the evident benefits of prolonged infusion of the aforementioned antibiotics, clinicians should strongly consider this mode of administration of relevant antibiotics, especially in patients with severe infections.

Reference:

Rafailidis, P. I. and Falagas, M. E. (2020) Benefits of prolonged infusion of beta-lactam antibiotics in patients with sepsis: personal perspectives. Expert Review of Anti-Infective Therapy. June 21st. https://doi.org/10.1080/14787210.2020.1776113. (epub ahead of print).

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